MECHANISMS OF TURBULENCE, SEXUAL INTIMACY CHALLENGES, AND SEXUAL COMMUNICATION IN DEPRESSED COUPLES
BY
AMY L. DELANEY
DISSERTATION
Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Communication
in the Graduate College of the
University of Illinois at Urbana-Champaign, 2016
Urbana, Illinois
Doctoral Committee:
Professor Leanne Knobloch, Chair Professor John Caughlin
Abstract
Symptoms of depression can permeate people’s relationships, making depression an inherently interpersonal illness (Hames, Hagan, & Joiner, 2013; Rehman, Gollan, & Mortimer, 2008). Depressed couples are especially prone to unique and pervasive challenges to their sexual relationship (Baldwin, 2001; Cleveland Clinic, 2014; Delaney, 2016). Delaney (2016)
documented depression-related sexual intimacy challenges as multi-layered and including lost libido, cognitive barriers, and interactive dilemmas, but a quantitative documentation of these challenges remains to be added to the literature. Sexual communication is linked to relationship and sexual satisfaction (Byers, 2005; Theiss & Solomon, 2007), but questions persist about best practices for defining and measuring sexual communication, and about the role communication about sex might play for depressed couples navigating sexual intimacy challenges. In this study, I integrated the premise of the marital discord model of depression (Beach, Sandeen, & O’Leary, 1990) with the logic of the relational turbulence model (Solomon & Knobloch, 2004) to
hypothesize a model that positioned depressive symptoms as a predictor of mechanisms of turbulence (H1), mechanisms of turbulence as predictors of sexual intimacy challenges (H2), and sexual intimacy challenges as predictors of sexual satisfaction (H3). I also hypothesized that sexual intimacy challenges would negatively predict sexual communication (H4), which would positively predict sexual satisfaction (H5). A final hypothesis suggested that sexual
communication would mediate the association between sexual intimacy challenges and sexual satisfaction (H6). I collected dyadic data from romantic couples in which one or both partners had been professionally diagnosed with a form of depression (N = 116) and used structural equation modeling to evaluate actor and partner effects. The final models offered mixed support for the hypothesized associations, as some paths were not statistically significant and path
additions were necessary to achieve model fit. The modified models revealed that depressive symptoms and interference from a partner predicted sexual intimacy challenges in depressed couples. The findings also uncovered relational uncertainty and interference from a partner as negatively associated with sexual communication. Finally, the data suggested that sexual communication exhibits an indirect effect connecting sexual intimacy challenges to sexual satisfaction. The findings contribute to theorizing about depression in romantic relationships, about the relational turbulence model, and about sexual communication. Pragmatically, the results point to minimizing mechanisms of turbulence and improving sexual communication as important areas for intervention with depressed couples.
Acknowledgements
This work would not be possible without the contributions of many people. First and foremost, I am immeasurably grateful for the guidance and support of my dissertation committee. Leanne, your mentorship has shaped me professionally and personally, and your investment in my work has made my scholarship better at every phase of the process. Thank you for your time, your insight, and your patience. John, you have taught me about asking significant questions, about thinking from different theoretical frameworks, and about polishing my writing. Your mentorship has enriched my time at Illinois since my very first visit to campus as a
prospective student. Brian Q., you have been enthusiastic about my ideas across my graduate career, and that enthusiasm has motivated me to do my best work. Brian O., in coursework, in defenses, and in conversation, you have pushed me to think theoretically and to consider tough methodological choices. I know your influence will resonate in future projects. My committee is an admirable group of scholars for whom I am greatly appreciative.
I’m also deeply thankful for the support provided by the Department of Communication and the University of Illinois Graduate College. My dissertation and the work leading up to it have been funded by the Ruth Anne Clarke Student Scholar Award, the Marion Morse Wood Fellowship in Interpersonal Communication, and the Graduate College Dissertation Completion Fellowship. I am grateful to be a part of an institution with so many resources for graduate study. To the Communication office staff who have helped me navigate the financial and logistical aspects of this project, I cannot thank you enough! And special thanks to the undergraduate research assistants who contributed across phases of this project: Isabelle Gordon, Blake Herrman, Emily Brennan, Kelly Kennedy, and Danielle Bertini.
Friendships inside and outside of academia have carried me through this process. To the other three members of the core four, our time spent together professionally and socially has been a highlight of my graduate career. Thanks for the laughs, the happy hours, and the snacks during writing group. Kristin and Sylvia, I’m grateful to call you my mentors and my friends. Thanks for listening, for making suggestions, and for always reminding me that there is a lot to look forward to after the dissertation fog clears. Renee, thanks for always checking in and encouraging me. I’d say you are a great cheerleader, but it’s probably better to say you’re a great coach. And finally, Erin, I hardly have words to thank you for your friendship. You are not a friend inside or outside of academia; you are family. You are my person. I can never repay you for all you’ve given me, and I look forward to many more goals lunches, binge-watching sessions, and time spent together with you and Nora.
Finally, my family has provided the foundation for me to grow into the person and scholar I am today. Mom, Dad, Jenna, Leah, Mariah, and Seth, thank you for believing in me. You have taught me to value my own worth and to use my own voice. I love you all so much. Amber, you gave my family a priceless gift by inviting Nora into your home so that I could get the time I needed to work on my dissertation. Thank you. This couldn’t have happened without you. My incredible husband, Tim, you have supported me in every way possible during this process, and I am grateful for you every day. Life is better because we are together, and everything is better with our amazing daughter.
Table of Contents
Chapter One: Introduction and Literature Review ...1
Chapter Two: Theoretical Framework and Research Objectives ...20
Chapter Three: Method ...41
Chapter Four: Results ...62
Chapter Five: Discussion and Conclusions...131
References ...173
Appendix A: Recruitment Materials ...196
Appendix B: Participant Emails...203
Chapter One: Introduction and Literature Review
Depression is a common but serious affective disorder that impacts approximately 16 million Americans each year (National Alliance on Mental Illness, 2012; National Institute of Mental Health, 2015b). Centers for Disease Control and Prevention (2011a) data indicate that nearly 10% of adult Americans suffer from depression, with around 4% meeting the criteria for major depression. Symptoms of depression are varied, but often include persistent feelings of sadness or emptiness, insomnia, irritability, a loss of interest in activities, and decreased energy (National Alliance on Mental Illness, 2012; National Institute of Mental Health, 2015a). Effects of depression can be debilitating for both the depressed individual and his or her romantic
partner. As Rehman, Gollan, and Mortimer (2008) noted, “depression has interpersonal causes, is interpersonally mediated, and interpersonal factors can predict depression relapse” (p. 180). In other words, depression affects and is affected by relational factors across the illness trajectory. Coyne’s work in the 1970s first helped to focus an interpersonal lens on the experience of depression, but a contemporary emphasis on cognitive and biological factors has overshadowed the study of relational processes (Segrin, 2000). Although the Centers for Disease Control and Prevention (2011b) recognize that interpersonal relationships are especially likely to be burdened by depression, there is a substantial lack of research on the complex interpersonal dynamics associated with depression (Joiner & Timmons, 2009). Examining depression from an
interpersonal perspective is crucial for understanding the causes and consequences of this mental illness (Segrin, 2000). Communication scholars represent an important voice in conversations
esteem, difficulties experiencing pleasure, and troubles initiating sexual activity (Baldwin, 2001; Kennedy, Dickens, Eisfeld, & Bagby, 1999; Ostman, 2008). Of course, non-depressed partners are affected by a depressed person’s difficulties with the sexual relationship, but some research suggests that non-depressed partners can face similar challenges (e.g., difficulties with physical function) as a result of their loved one’s depressive illness (Ostman, 2008). Yet, gaps remain in the study of sexuality in depression. Most depression literature designates decreased libido as a symptom of depression (e.g., Kennedy et al., 1999) or a side effect of medication used to treat the depression (e.g., Higgins, Nash, & Lynch, 2010) and has thus ignored the relational dynamics that may drive sexual intimacy challenges for depressed couples. Laurent and Simons (2009) summarized research on decreased libido, difficulties with arousal (such as erectile dysfunction), orgasm and pain disorders, and reduced pleasure and satisfaction, showing that sexual intimacy challenges can extend beyond drive and function. Existing research also fails to document non-depressed partners’ experiences in this domain, offering an opportunity for relationship scholars to contribute to the literature on depression.
Couples facing sexual difficulties may find it particularly daunting to communicate about the physical relationship. Sexuality is a taboo conversational topic in most relationships
(Anderson, Kunkel, & Dennis, 2011; Baxter & Wilmot, 1985). Partners are likely to avoid conversations about the sexual aspects of their relationship, and avoidance of these conversations typically associates with decreased sexual satisfaction (Anderson et al., 2011; Theiss & Estlein, 2014). Despite its importance in shaping the relationship climate, sexual communication is an under-researched process in the study of close relationships (Sprecher & Cate, 2004). A dissertation that explicates how depressed couples face sexual intimacy challenges and how
communication about sex shapes those relational experiences will move the depression and sexual communication literatures forward in both theoretical and practical ways.
Three primary objectives guide this dissertation. First, I seek to add insight to theory and research in the study of depression in romantic relationships by testing the relational turbulence model (Solomon & Knobloch, 2004) in this context. This application will offer a valuable test of the model’s predictive power in the study of depression and will add to literature positioning communication as central to processes of turbulence in close relationships. Second, I aim to contribute to the depression literature by (a) delineating the spectrum of sexual intimacy challenges for couples with depression, (b) investigating associations between sexual intimacy challenges, sexual communication, and sexual satisfaction, and (c) providing practitioners with insight into how to better help couples manage their relationship while battling depression. Finally, I intend to bolster the empirical rigor of the study of depression and sexual
communication by collecting dyadic data and obtaining both qualitative and quantitative insight into couples’ experiences.
Depression and Romantic Relationships
Depression is associated with a wide range of relationship troubles and exhibits a negative and reciprocal connection with relationship quality (Davila, Bradbury, Cohan, &
Tochluk, 1997; Whitton & Whisman, 2010). Relationships involving individuals with depression tend to be characterized by rejection, dissatisfaction, low intimacy, and decreased involvement (Hames, Hagan, & Joiner, 2013). A bidirectional negative relationship likely exists between
couples (Hames et al., 2013; Whisman, Robustelli, Beach, Snyder, & Harper, 2015). Depression impacts partnerships across the relational trajectory, including in formation, satisfaction and functioning, and dissolution (Davila et al., 2009). Even in instances where partners have relatively low levels of depression, the symptoms can still predict challenges for interpersonal romantic relationships (Kouros & Cummings, 2011). Longitudinal work suggests that decreases in relationship satisfaction align with increases in symptoms of depression (Whisman, 2013). The ties between relationship quality and depressive symptoms are well documented, and researchers have turned their attention to identifying mechanisms that drive these associations.
Some relationship troubles may be rooted in problems with communicating effectively for depressed couples (Gabriel, Beach, & Bodenmann, 2010; Sharabi, Knobloch, Delaney, 2016). Couples with depression experience several communication struggles, such as increased conflict and criticism, negative emotional responses, difficulties providing support, and hostility (Davila, 2001; Duggan & LePoire, 2006; Kouros & Cummings, 2011). Depression is associated with poorer relational functioning in areas such as problem solving, social support, and coping with relational events (Davila et al., 2009). The day-to-day challenges of managing depression can also exacerbate relationship troubles (Smith, Breiding, & Papp, 2012). The depression in relationships literature points to numerous barriers for couples in maintaining a close and satisfying partnership, including communication deficits. On top of that, depressed couples are likely to experience sexual problems, and these difficulties can not only damage the relationship, but also undermine depression recovery (Baldwin, 2001; Cleveland Clinic, 2014).
Depression and the Sexual Relationship
Sex problems in the depression context are common, appearing in over 70% of patients with depression (Casper et al., 1985). Laurent and Simons (2009) noted that a link exists between
mental illness and sexual functioning, claiming that depressed individuals are five times more likely to experience a sexual desire disorder. For example, Kennedy et al. (1999) sampled 134 depressed individuals and found that 50% of women and 42% of men reported a decrease in sexual desire. Forty-six percent of men experienced an inability to sustain an erection and 50% of women struggled with decreased sexual arousal. Frohlich and Meston (2002) found that college-aged women exhibiting depressive symptoms reported more sexual problems (e.g., difficulty with orgasm, sexual pain) than a control group, and reported less satisfaction with sexual relationships. Existing research has emphasized difficulties with desire, function, and satisfaction for depressed individuals. Eklund and Ostman (2010) asserted, however, that not enough is known about sexuality in the context of relationships marked by mental illness because most research has focused on sexual dysfunction, as it is more prevalent in those suffering with mental illness than the general population. Although scholars and practitioners acknowledge the prevalence of sex problems for individuals with depression, less is known about how sexual intimacy challenges can extend beyond libido and function.
Several possible sexual intimacy challenges exist for individuals with depression and their partners, and a focus on only decreased libido in depression misses the full picture of the sexual challenges depressed couples experience. Sexual problems in depression might be the result of a chemical imbalance, making desire and function challenging, or the sexual problems could be the result of the strain depression puts on the relationship (Cleveland Clinic, 2014). Sexuality is likely to be affected by depression through a lowered or lost libido, but partners may
Laurent and Simons (2009) explained that depression can be linked to a spectrum of sexual challenges (e.g., reduced satisfaction and pleasure, difficulties with orgasm, etc.), not just decreased interest. Partnerships marked by depression can also be impacted by varying emotional, physical, and relational sexual difficulties. Baldwin (2001) explained that sexual response disorders can happen on one of four phases: desire, excitement, orgasm, and resolution, but also notes that when one aspect of the sexual relationship is affected, other areas may be impaired as well. Even in non-clinical couples, relational quality and sexual satisfaction are related to not only one’s own depressed mood, but also a partner’s depressed mood (Bodenmann & Ledermann, 2007). The effects of depression on a couple’s sexual partnership are multifaceted and prior research hints at relational issues that might affect both partners.
Qualitative findings underscore the complexity of this issue. In interviews with clinically depressed individuals and their partners, Ostman (2008) found that patients felt a desire for physical intimacy, but struggled to act on those desires. Ostman (2008) also found that non-depressed partners became reluctant to act on their own sexual desires, indicating that even partners without depressive symptoms can become inhibited. Sharabi et al. (2016) analyzed open-ended accounts of depression’s relational effects and identified sexual intimacy as a negative consequence of depression for both patients and partners. Specifically, participants recognized issues with both frequency and desire as a result of depression. In an interview study on depression and sexual relationships, Delaney (2016) documented two layers of challenges that extend beyond a partner’s decreased libido. Cognitive challenges refer to difficulties with self-esteem and feelings of isolation that can interrupt a couple’s ability to connect sexually.
about their sexual partnership and feel unable to initiate sexual activity with a partner. The
challenges to a depressed couple’s sexual relationship are complex, multi-layered, and pervasive. Sexual dysfunction and dissatisfaction are often dismissed as side effects of the
medication used to treat the other symptoms of depression. Yet, it can be difficult to disentangle sexual intimacy challenges that are a result of medication from those that are a result of the illness itself (Baldwin, 2001). Kennedy et al. (1999) emphasized that the baseline effects of depression on sexuality should be considered when measuring effects of medication. Sexual problems are more common in depressed individuals who receive treatment than those who do not, but even untreated depressed people have higher incidence of sexual challenges than non-depressed individuals (Baldwin, 2001). Kennedy and colleagues (1999) sampled patients with major depression and found that severity of depressive symptoms was not associated with sexual dysfunction. Instead, women’s personality characteristics such as higher neuroticism and lower extroversion were correlated with sexual dysfunction. These findings suggest that factors beyond severity of depressive symptoms are important to consider in examining sexual intimacy in couples coping with depression (Kennedy et al., 1999). Finally, Baldwin (2001) also argued that measurement of sexual dysfunction is critical, noting that scholars must differentiate between normal sexual dysfunctions and those associated with depression, as well as dysfunctions associated with medication.
The ties between depression, medication, and sexual challenges do not have a clear causal order. Laurent and Simons (2009) asserted that the relationship between depression and
or side effect. Scholars have turned their attention to the side effects of anti-depressant
medication without fully exploring the link between depression itself and the sexual challenges faced by patients and their partners (Kennedy et al., 1999). As a whole, these findings point to a need to parse out sexual challenges that may be completely unrelated to depression, those that stem from the depression, those that are indirectly related to the depression, and those that are caused by medication used to treat the depression.
In sum, the literature contains strong evidence of a link between depression and
substantial challenges to having a satisfying and fulfilling sexual relationship. A majority of this research comes from a clinical psychology perspective, however, leaving room for experts on communication in relationships to lend their voice to the conversation about depression and interpersonal relationships. As Reynaert and colleagues (2010) affirmed, scholars should attend to the emotional, behavioral, and relational factors associated with depression and sexual dysfunction and dissatisfaction. Individually, sexual dysfunction and mental illness can be detrimental to an individual’s quality of life, and in combination, depression and sexual intimacy challenges can have an intensely negative effect on partners (Laurent & Simons, 2009).
Moreover, clinicians can benefit from being better able to support patients and their partners as they navigate the sexual challenges associated with depression (Bodenmann & Ledermann, 2007; Ostman, 2008). Further research in the realm of relationships is needed to understand what these sexual challenges mean in the context of romantic partnerships and to highlight the most effective strategies for individuals and couples to cope with those challenges.
Sexual Communication in Romantic Relationships
The sexual connection between romantic partners plays a crucial role in the early stages, maintenance, and potential termination of relationships (Dewitte, 2014). The quality of the
sexual relationship may even predict relational stability, as suggested by Sprecher’s (2002) longitudinal findings. Moreover, the dynamics of communication about sex between romantic partners can have both sexual and relational outcomes (Byers, 2005; Dewitte, 2014; Faulkner & Lannutti, 2010). Scholars have established that intimacy between partners is intricately tied to both the sexual connection and the interpersonal climate of the relationship (Theiss & Solomon, 2007). For example, sexual communication can influence emotional outcomes for partners, and frequency and quality of interactions are tied to overall relationship satisfaction (Sprecher & Cate, 2004; Theiss & Solomon, 2007). Conversations surrounding sex, though, are not always easy for partners. Sexuality is a taboo topic, and partners can struggle to engage in conversations about sex at various points in their relationships (Anderson et al., 2011; Baxter & Wilmot, 1985; Theiss, 2011; Theiss & Solomon, 2007). The sexual intimacy and interpersonal communication literatures both stand to benefit from increased attention to the ways couples communicate about their sexual relationship.
Defining sexual communication. A pressing task in the sexual communication literature is to accurately and comprehensively define this construct. Scholars have provided a range of conceptualizations. Sexual communication is comprised of both verbal (e.g., explaining a sexual preference to a partner) and nonverbal (e.g., eye contact) cues (Babin, 2013; Hess & Coffelt; 2012; Theiss & Solomon, 2007). Mark and Jozkowski (2013) described sexual communication in quite general terms, referring to it as “communication regarding sexual aspects of the
refusal, and (b) disclosure of likes and dislikes. Green and Faulkner (2005) also provided a specific list of discussions that meet their broad conceptualization of sexual communication: safer sex, sexual health, sexual pleasure, and sexual limits (p. 239). Metts and Spitzberg (1996) advocated a definition that focuses on processes of coming together and negotiating within the relationship. Their description asserted that sexual communication is “the means by which individuals come to select potential partners for sexual relations, and through which the
meanings, functions, and effects of sexual relations are negotiated” (Metts & Spitzberg, 1996, p. 49). This group of definitions suggests a broad approach to sexual communication.
More narrow conceptualizations also exist. A number of researchers have highlighted sexual self-disclosure as the hallmark of sexual communication, and also prioritized “openness” in these interactions (e.g., Byers & Demmons, 1999; Montesi, Fauber, Gordon, & Heimberg, 2011; Rehman, Rellini, & Fallis, 2011). This may include the sharing of fantasies, desires, preferences, and dislikes between partners. Theiss (2011) also aligned sexual communication with open and direct communication about sexual desires. These definitions are specific in how they center on the exchange of information about sex between partners. Babin (2013) asserted, though, that sexual communication should encompass a range of conversations (not just individuals’ self-disclosure), including safe sex decisions, scripts for interactions, consent, initiation and refusal, and disclosure. Quina, Harlow, Morokoff, Burkholder, and Deiter (2000) also found that conversations about sexual pleasure and conversations about sexual health are not the same, providing further rationale for a multi-dimensional structure for understanding sexual communication. Indeed, there are both broad and specific ways to conceptualize sexual
communication, and the literature lacks consensus on exactly what scholars are examining in their studies of “sexual communication”.
This dissent in the literature may be partially a result of the taboo nature of talking about sex in general (Baxter & Wilmot, 1985). Communication relating to sexual intimacy is often passive and indirect, making it difficult for partners to decipher and for researchers to measure, particularly if scholars are defining the construct as open and direct (Theiss & Solomon, 2007). Further, most research on sexual communication has focused on communication surrounding sex that occurs outside of sexual situations, with less emphasis on how partners communicate during sexual encounters (Babin, 2013). Sexual communication is challenging for partners because it can put them at risk of rejection, threaten their self-confidence, be embarrassing, or endanger the relationship (Montesi et al., 2011; Theiss & Estlein, 2014). For example, some individuals would rather have unprotected sex than have a conversation about protection (Pliskin, 1997). Many individuals do not see sex as an easy topic for conversation, making it difficult for scholars to pin down exactly what constitutes sexual communication.
Some scholars have chosen to focus on sexual communication satisfaction, highlighting participants’ perceptions of these interactions as opposed to the dynamics of conversations (e.g., Hess & Coffelt, 2012). For example, Wheeless, Wheeless, and Baus (1984) described sexual communication satisfaction as one’s satisfaction with communication about behavior, communication about which behavior(s) are satisfying, satisfaction that comes from
communication about sexual behaviors, and willingness to communicate about sex with a partner (p. 221). Byers and Demmons (1999) pointed out that it is important to also look at the content and process of communication about sex, not just individuals’ perceptions of satisfaction in those
Communication scholars who are interested in the dynamics of couples’ sexual relationships need to first explicate their conceptualization of sexual communication.
Sexual satisfaction, relationship satisfaction, and communication. Scholars have attended to questions about couples’ relationship and sexual satisfaction, as well as the role communication may play in these relationship dynamics. Sexual satisfaction and relationship satisfaction are closely (and probably bidirectionally) linked, and sexual satisfaction is also a noted predictor of relationship stability (Byers, 2005; Sprecher & Cate, 2004). Sexual
satisfaction is linked with relationship satisfaction, love, and commitment (Sprecher, 2002). Christopher and Kisler (2004) noted that most scholars argue that sexual satisfaction is the precursor to marital satisfaction, but others argue that the opposite is true (e.g., Byers &
Demmons, 1999). Some studies (e.g., Byers, 2005; Sprecher, 2002) have concluded that neither seems to be causally linked to the other. Mark and Jozkowski (2013) reviewed research
indicating that relationship satisfaction and sexual satisfaction likely move concurrently, and neither necessarily precedes the other. Convincing evidence exists that relationship quality and partners’ sexual satisfaction are closely tied, and recent scholarship implies that these indicators work synchronously, as opposed to one causing the other.
Communication might account for the similar changes in relationship and sexual satisfaction over time because the way people communicate about sex is intricately linked to emotional, cognitive, and relational outcomes of sexual activity (Byers, 2005; Theiss &
Solomon, 2007). For example, in a study on initial sexual experiences between partners, Theiss and Solomon (2007) found that direct communication about sex was positively associated with desirable sexual outcomes, such as positive emotions, optimistic cognitions about the
There is likely a positive reciprocal relationship between conversations about initiation of sexual activity (and the outcomes of those conversations) and relationship satisfaction (Sprecher & Cate, 2004). Rehman and colleagues (2011) found both actor and partner effects for the connection between sexual self-disclosure and sexual satisfaction, in that one’s self-disclosure about sexual likes and dislikes predicts one’s own and one’s partner’s sexual satisfaction. Hess and Coffelt (2012) documented a link between the specific type of language married partners use to talk about sex and their satisfaction with sexual communication and overall relational quality. Satisfying conversations about sex can also have positive relational and sexual outcomes by providing individuals with an opportunity to better understand his/her partner’s sexuality (Faulkner & Lannutti, 2010). Further, sexual satisfaction for both partners should improve as couples are able to agree about frequency and nature of sexual activities, a process that likely necessitates communication about sex (Snyder & Berg, 1983). These findings suggest that sexual communication is an important factor in the sexual climate of romantic relationships.
Although there is evidence that communication in general is associated with relationship and sexual satisfaction over time (e.g., Byers, 2005), conflicting findings exist in terms of the role sexual communication plays in sexual and relationship satisfaction. Overall communication and sexual communication are both important for a satisfying sexual partnership (Cupach & Comstock, 1990). Whereas some studies have not documented a link between sexual
communication and satisfaction with sex or in the partnership (Byers & Demmons, 1999), other findings indicate that both frequency and quality of sexual communication are associated with
individual’s sexual self-disclosure contributes to overall relationship satisfaction, which in turn, influences sexual satisfaction. In the instrumental pathway, individuals are more sexually satisfied when they can disclose about sexual likes and dislikes in order to improve their partner’s understanding of sexual preferences. In other words, the expressive pathway hypothesizes a mediated link between sexual self-disclosure and satisfaction, and the
instrumental pathway hypothesizes that the disclosure directly facilitates more rewarding sexual interactions. An important step in the sexual communication literature is to identify the role that communication between partners plays in sexual and relationship satisfaction processes.
Support exists for both explanations. Cupach and Comstock (1990) found that sexual satisfaction mediates the relationship between sexual communication satisfaction and marital adjustment, providing support for the instrumental pathway. This suggests that satisfying conversations about sex may improve relationship satisfaction by facilitating more satisfying sexual relationships. Montesi et al. (2011) described results consistent with this finding, indicating that sexual satisfaction plays a mediating role between sexual communication and relationship satisfaction. MacNeil and Byers (2005) found support for the expressive pathway for women and support for the instrumental pathway for both men and women. Mark and Jozkowski (2013), however, asserted that the structure of this relationship may actually place
communication as the mediator between relationship satisfaction and sexual satisfaction. In their study of heterosexual dyads, both sexual and non-sexual communication mediated the
association between relationship and sexual satisfaction. Taken together, these conflicting findings indicate that the ties between sexual communication, sexual satisfaction, and relationship satisfaction are complex and worthy of further study. In any case, sexual communication is a critical component of sexual satisfaction, along with other individual,
relational, and cultural factors (Babin, 2013; Carpenter, Nathanson, & Kim, 2009). The sexual communication literature reviewed thus far suggests two avenues for advancing knowledge on how romantic couples communicate about sex. First, scholars can examine the pathways previously established with different conceptualizations of sexual communication. Second, scholars should sketch theoretical frameworks for how communication facilitates satisfaction in sexual relationships.
Sexual communication is challenging. Despite evidence for the importance of talking about sex, many individuals find sexual communication with a partner particularly challenging or dissatisfying. Although direct sexual communication may be key for satisfying sexual relationships (Theiss & Solomon, 2007), the taboo nature of talking about sex could explain individuals’ discomfort and avoidance of these conversations. In their study on taboo topics in romantic relationships, Anderson and colleagues (2011) found that partners avoided
conversations about their sexual history for multiple reasons, including leaving the past in the past, engaging in identity management, avoiding a threat to the relationship, and trying not to upset their partner. Faulkner and Lannutti (2010) found that young adults’ unsatisfying
conversations about sex were likely to center on relationship issues or making decisions, such as sexual pleasure and sexual health decisions. A lack of response to a sexual request can also associate with sexual dissatisfaction (Snyder & Berg, 1983). Evading conversations about sex is common, but the avoidance of sexual conversations negatively associates with sexual satisfaction (Theiss & Estlein, 2014).
Individuals who experience high levels of social anxiety are likely to not only find sexual communication challenging, but are also likely to be less sexually satisfied in their sexual relationships (Montesi et al., 2013). In sum, romantic couples are prone to sexual and relational consequences as a result of their difficulties engaging in sexual communication.
Sexual communication can be problematic for partners across the relationship trajectory, including dating (e.g., Theiss & Solomon, 2007) and married (e.g., Theiss, 2011) couples. For example, partners typically engage in very little sexual communication prior to first intercourse, and that communication can be indirect or passive (Theiss & Solomon, 2007). This suggests that sexual communication could be more challenging at the beginning of the relationship. Yet, married couples can be prone to indirect and ineffective sexual communication as well (Theiss, 2011). Further, Wheeless et al. (1984) found that satisfaction with sexual communication varies greatly across relationship development and deterioration, indicating a need to examine these processes at differing points in partnerships. Indeed, communication about sexual issues such as consent, desires, history, or protection can have different meanings and consequences with a committed partner versus a new or more casual partner (Quina et al., 2000). Theiss (2011) adds to this picture by noting that relational uncertainty (or a lack of confidence in perceptions of the relationship; Knobloch & Solomon, 1999) could be a barrier to effective sexual communication, making it challenging for couples to maintain a satisfying sexual connection. Although the content of relational uncertainty differs in diverse relationship circumstances (Knobloch, 2008), uncertain appraisals of the partnership could make conversations about sex particularly difficult for partners. In short, romantic partners face obstacles in discussing their sexual connection throughout the relationship.
Sexual communication is nuanced and requires negotiation of many competing desires. Partners must communicate in ways that allow them to send and receive information, but also negotiate the relationship, attend to identity goals, manage face threats, protect a partner’s feelings, etc. Although some literature suggests partners should communicate and disclose openly about sexual topics (e.g., MacNeil & Byers, 2005; Theiss & Solomon, 2007), partners might be more likely to use passive or indirect tactics (Theiss, 2011). On the one hand, Theiss and Solomon (2007) argued that direct communication is preferable and leads to positive relationship outcomes, and Theiss and Estlein (2014) pointed to topic avoidance and indirect communication as particularly problematic for couples discussing sexual intimacy. On the other hand, there is evidence that indirect communication may, in some cases, be most appropriate for partners. Quina et al. (2000), for example, point out that gendered expectations for relationships make it possible that indirect communication is more appropriate for women, while men are able to be more assertive in discussing sexuality issues. As an additional example, romantic partners send subtle cues of their interest in participating in sexual activity or communicate consent by simply not rejecting a partner’s advance (Theiss & Solomon, 2007). Indirect strategies such as these may be less effective in meeting immediate goals than more direct communication
techniques. Indirect communication can, however, serve to protect the relationship and the other partner, and this strategy may be a response to the threatening nature of talking about sex in close relationships (Theiss & Estlein, 2014). By focusing only on “direct” or “open” communication as effective for sexual relationships, relationships scholars are likely to miss out on the intricacies
interpersonal conversations. For example, Theiss and Solomon (2006a) claimed that in the context of communicating about irritations in romantic relationships, partners must grapple with multiple concerns, including the severity of the relationship problem, qualities of the
relationship, and individual communication tendencies. Directness may not always be the most desirable communication option for negotiating challenging conversations, such as those about irritations, or those about sexual issues. Several theories of interpersonal communication offer explanations for why.
Theorizing about avoidance of conversations hints that avoiding direct conversations is sometimes desirable for romantic couples. Topic avoidance is typically considered to be a negative for relationships, but certain strategies for avoiding conversations (e.g., complimenting or showing affection for a partner) may actually lead to desirable relationship outcomes (Dailey & Palomares, 2004). Petronio’s (2002) communication privacy management theory speaks to ways that individuals seek to balance openness with privacy in their communication with others, suggesting that completely open and direct communication is likely not desirable. More
specifically, some privacy-focused motivations for avoiding may moderate how avoidance affects outcomes (e.g., Caughlin and Afifi, 2004).
Politeness theory (Brown & Levinson, 1987) also offers insight into the nuances of relational communication. Politeness theory informs scholarship on relational communication by positing that partners negotiate desires to maintain positive face (self-image) and negative face (autonomy). Further, interactants are obliged to attend to both their own and their partner’s face threats. The assumptions of politeness theory have evolved, but scholars tend to agree that management of face threats is a relational process that unfolds in conversation (Johnson, Roloff, & Riffee, 2004; Locher & Watts, 2005). Politeness theory suggests that avoidance, indirectness,
and other communication strategies may help partners mitigate face threats in conversations about sex. Moreover, individuals who are experiencing relational uncertainty (i.e., questions about involvement in the relationship) appraise messages as potentially more face threatening (Knobloch, Satterlee, & DiDomenico, 2010). Individuals suffering from depression, as well as individuals coping with sexual intimacy challenges, are likely to encounter relational uncertainty, necessitating some management of those face threats in conversation.
Scholarship on interpersonal communication illustrates the complexity of engaging in conversations on a taboo topic such as sex and suggests that direct or straightforward
communication tactics may not always be most desirable for partners. More nuanced insight is warranted into the ways couples navigate challenging conversation about challenging sexual situations, and assumptions about direct communication as most effective should be questioned.
Summary. With this dissertation, I seek to bridge the literatures on depression in romantic relationships and sexual communication. Relationships marked by depression are understudied and present unique challenges for partners, particularly in the realm of maintaining a satisfying sexual connection (Joiner & Timmons, 2009; Laurent & Simons, 2009). The
literature on sexual communication suggests that partners’ interactions about their sexual connection are both complex and important for the overall climate of the relationship. Thus, a study on sexual intimacy challenges and sexual communication in the context of depression has potential to (a) enrich the literature on depression in romantic partnerships, (b) highlight
Chapter Two: Theoretical Framework and Research Objectives
Both the depression and sexuality literatures have suffered from a lack of theoretical underpinning, despite well-established findings on the impact of depression on relationships and the role sexual communication plays in romantic partnerships. Scholarship that hinges on the application of theory to explain the dynamics of communication about sex in relationships marked by depression is poised to make meaningful contributions to these literatures. Theories such as the social skills deficit perspective, interactional theory, and integrative interpersonal theory each make assertions about the ties between relationship problems and depression (Hames et al., 2013). My theorizing started by consulting the marital discord model (Beach et al., 1990, 1993), which illuminates communication as a link between relationship issues and depression. To frame my hypotheses, I then turned to the relational turbulence model (Solomon & Knobloch, 2004). The relational turbulence model illuminates how interdependence between partners and uncertainty surrounding the partnership can be tied to conversations and relationship outcomes. I also prioritized a dyadic approach to depression in romantic partnerships. Examining the
dynamics of depression from a dyadic standpoint is a useful way to evaluate both actor and partner effects and account for interdependence in close relationships (Bodenmann & Randall, 2013; Kenny, Kashy, & Cook, 2006). In the following sections, I review each framework and highlight its utility in the study of depression and sexual communication. I also draw upon these theories and existing research to propose several research questions and hypotheses. Please refer to Figure 1 for a visual representation of the proposed model.
Quality of Sexual Communication Depressive Symptoms Relational Uncertainty Interference from a partner Sexual Intimacy Challenges Sexual Satisfaction a g b c d e f
Theories of Depression
Scholars interested in the study of depression and romantic partnerships can turn to a handful of theories to inform their investigations. Segrin’s (1990, 2000, 2001) social skills deficit (SSD) perspective asserts that basic differences in social behaviors exist between depressed and non-depressed individuals, pointing to diminished social skills as the culprit for relationship challenges in depression. Coyne’s (1976a, 1976b) interactional theory suggests that depressed individuals are rejected by others through a cyclical process of reassurance seeking and increased negative affect (Hames et al., 2013; Joiner & Metalsky, 1995). Interactional theory assumes that it is irritating and frustrating to interact with a depressed person, and thus, depressed people can produce symptoms of depression in their close relationship partners (Segrin, 2001). Integrative interpersonal theory (IIT; Joiner & Metalsky, 1995) refines Coyne’s perspective by (a) asserting that excessive reassurance seeking is the particular behavior that leads to rejection and (b) additionally identifying negative feedback seeking as a rejection-inducing interpersonal behavior. The social skills deficit perspective positions social skills as central to depressed relationships, while interactional theory and integrative interpersonal theory focus on processes of rejection, but these theories do not highlight the dyadic processes that are salient as couples grapple with sexual challenges. The marital discord model is a useful lens for initiating thinking about interdependent and communicative processes in depressed partnerships.
The Marital Discord Model of Depression
The marital discord model of depression (MDD; Beach & O’Leary, 1993; Beach, Sandeen, & O’Leary, 1990) asserts that marital relationships are important to consider in the development and maintenance of depressive symptoms. The MDD acknowledges the intricate link between relationships and depression, claiming that marital discord triggers depression
through reductions in support and increases in stress and hostility (Beach et al., 1990; Fincham, Beach, Harold, & Osborne, 1997; Rehman et al., 2008). Research on the association between marital functioning and depressive symptoms suggests that negativity in romantic relationships can lead to a perceptual shift, making individuals susceptible to both depression and relationship discord (Whisman et al., 2015). The original formulation of the MDD (Beach et al., 1990) proposed that marital discord precedes depression. The authors did, however, acknowledge the role that depression can play in the development and endurance of marital discord (p. 78) and accounted for some reciprocal influence. Broadly, then, the MDD is a theory that speaks to the ties between relationship functioning and depressive symptoms.
The MDD posits that relationship challenges and depression are linked through increases in negative interaction and decreases in positive interaction (Beach et al., 1990; Rehman et al., 2008). The MDD also suggests that depression is associated with heightened reactivity to marital stressors (Beach & O’Leary, 1993). The theory further posits that the presence of marital discord and severe marital stressors precipitate a major depressive episode, and that depressed
individuals are likely to see relationship events as catastrophic (Beach, Katz, Kim, & Brody, 2003; Beach & O’Leary, 1993). Consequently, the MDD asserts that the link between marital trouble and depression is driven by an increase in negative behaviors and a decrease in positive behaviors in the relationship. Scholars have employed the MDD to point to the effects of marital quality on depression, the role of gender in this process, and the need to examine the link
Helms, & Buehler, 2007), as opposed to examining the particular behaviors suggested by Beach and colleagues (1990).
The marital discord model is useful for the current examination in two ways. First, the model emphasizes the importance of considering the depression experience alongside relational experiences. Originally advanced as a framework for treatment (c.f. Beach et al., 1990), the MDD underscores how examining dyadic processes can serve as intervention for both the depression and the relationship. Second, although it does not specifically speak to sexual intimacy challenges, the marital discord model can enhance the study of depression and sexual intimacy challenges by designating communication processes as a mechanism through which depression and relationship troubles are linked. Given these considerations, I recommend the relational turbulence model as a theory of relationships that has potential to link the depression and sexual communication literatures. In the sections that follow, I describe the relational turbulence model, highlight areas where the logic of the two theories overlaps, and propose several research objectives rooted in the relational turbulence model.
The Relational Turbulence Model
The relational turbulence model (RTM; Solomon & Knobloch, 2004) explains that romantic partners perceive their relationship as chaotic when in flux because they are
experiencing uncertainty about the relationship and interference from their partners in their daily routines (Knobloch, 2007b). Relational uncertainty is the degree of confidence individuals have in their perceptions of involvement and stems from self, partner, and relationship sources (Solomon & Knobloch, 2004). Self uncertainty includes people’s questions about their own involvement in the relationship, while partner uncertainty focuses on people’s questions about their partner’s involvement in the relationship. Relationship uncertainty focuses on the dyad and
encompasses questions about the partnership as a whole (Knobloch, 2008). These three overlapping but discrete sources of ambiguity contribute to turmoil in relationships because partners are limited in their abilities to make sense of the relationship when they are entertaining uncertainty about involvement in the partnership (Knobloch & Theiss, 2010). Interference from a partner is the degree to which a partner disrupts an individual’s ability to achieve his or her day-to-day goals (Solomon & Knobloch, 2004). The theory posits that disruptions to routines occur when patterns of interdependence shift and can spark reactivity. Broadly, the RTM argues that relational uncertainty and interference from a partner are mechanisms of relational turbulence, which is manifest in emotional, cognitive, and communicative reactivity in partners (Knobloch & Theiss, 2010; Theiss & Solomon, 2006a).
The RTM is particularly well-suited to guide investigations into the experiences of couples grappling with depression. Although developed to study the progression of relationships from casual to serious (c.f. Solomon & Knobloch, 2004), the RTM has recently been employed to examine how couples experience challenging health situations such as infertility and breast cancer (Steuber & Solomon, 2008; Weber & Solomon, 2008). Transitions are characterized by a need to adapt to new circumstances, and these new circumstances can certainly occur beyond courtship (Solomon, 2015). Moreover, scholars’ use of the model has expanded beyond the examination of relational transitions to consider processes that are salient throughout
relationships, including communication of hurtful messages, threatening conversations about sex, and experiences of jealousy (McLaren, Solomon, & Priem, 2012; Theiss & Estlein, 2014; Theiss
defined transition, but the model’s suitability for the study of health challenges and relationship processes makes it a strong framework to apply here. Next, I overview existing research that has drawn on the RTM to investigate (a) depression and (b) sexual relationships.
Relational turbulence and depression. Research rooted in the tenets of the relational turbulence model has produced evidence that the RTM serves as a valuable framework for examining the experience of depression in romantic relationships. One application of the RTM is to examine context-specific content areas of relational uncertainty and interference from a
partner within depression. Self, partner, and relationship uncertainty are relevant across
relationship types, but the content of people’s questions about their relationships can depend on the relationship context (Knobloch, 2007a, 2008; Mikucki-Enyart, Caughlin, & Rittenour, 2015; Theiss & Nagy, 2013). In health contexts, such as infertility and breast cancer, and relationship contexts, such as a post-deployment reunion and in-law relationships, scholars have documented unique content areas of relational uncertainty and interference from a partner (Knobloch & Theiss, 2012; Mikucki-Enyart et al., 2015; Steuber & Solomon, 2008; Weber & Solomon, 2008). To document how mechanisms of turbulence may be unique in the depression context, Knobloch and Delaney (2012) examined the online discourse of individuals who suffer from depression and partners of depressed persons. Their analyses revealed depression-specific content areas of self, partner, and relationship uncertainty, as well as unique ambiguities surrounding the depression itself. Knobloch and Delaney (2012) also documented depression-specific interference from a partner in the data through people’s discussions of disruptions to daily routines, challenges to personal well being, and disruptions to goals for the relationship.
In addition to illuminating content-specific mechanisms of turbulence, the RTM is valuable for documenting ways that the experience of depression can be a catalyst for relational
turbulence and can influence outcomes for couples coping with depressive symptoms. In a sample of returning military service members, the mechanisms of the RTM mediated the link between depressive symptoms and relational satisfaction (Knobloch & Theiss, 2011). Knobloch and Knobloch-Fedders (2010) found that the association between depressive symptoms and relationship quality was mediated by relational uncertainty for both women and men. Knobloch, Knobloch-Fedders, and Durbin (2011) combined the logic of integrative interpersonal theory with the construct of relational uncertainty to assess how ambiguity about the relationship may explain reassurance-seeking and negative-feedback seeking behaviors. They found that relational uncertainty was associated with negative feedback seeking behavior, indicating that depressed individuals who are experiencing ambiguity about the relationship may be inclined to
communicate in ways that confirm their negative self-view.
The RTM has demonstrated utility in explaining the experiences of couples with depression. Yet, the bulk of work has highlighted relational uncertainty in depression without attending to interference from a partner. Knobloch and Delaney (2012), however, found
examples of both relational uncertainty and interference from a partner in the online discourse of depressed individuals and partners of depressed individuals, so a full test of the model’s
predictive assertions will bolster the literature. Previous research has hinted at ways that relational uncertainty and interference from a partner may be apparent in the depression
experience. The self-doubt, anxiety, and pessimism associated with depression likely fuel a lack of confidence in the relationship, and symptoms such as irritability and a loss of interest in
H1a: Depressive symptoms will be positively associated with relational uncertainty. H1b: Depressive symptoms will be positively associated with interference from a partner. Relational turbulence and sexual intimacy challenges. Delaney’s (2016) findings represent a starting point for theorizing about sexual intimacy challenges in depressed couples by explicating couples’ challenges as centering on issues with libido, cognitive difficulties, and troubles with interactions. I surmise that relational uncertainty and interference from a partner will be positively associated with sexual intimacy challenges. As a foundation for this theorizing, I turn to the cognitive and interactive challenges described earlier (Delaney, 2016). Sexual intimacy challenges in depression are multi-layered and complex (Eklund & Ostman, 2008; Kennedy et al., 1999; Laurent & Simons, 2009). In addition to well-documented challenges related to libido and interest (e.g., Baldwin, 2001; Delaney, 2016), couples might cope with cognitive challenges related to self-esteem and isolation and/or interactive challenges related to conversations and initiation of sexual activity (Delaney, 2016). Further research is needed, however, to verify and supplement Delaney’s (2016) conceptualization of sexual intimacy challenges. To continue investigating the unique and varied sexual intimacy challenges for depressed couples, and to complement the evaluation of H2, I advance a first research question.
RQ1: What sexual intimacy challenges do depressed individuals and their partners face? According to the RTM, relational uncertainty and interference from a partner spark turbulence by making it difficult to communicate effectively and by provoking negative
evaluations of relationship events (Solomon, 2015; Solomon & Knobloch, 2004). For depressed couples, heightened relational uncertainty and interference from a partner might be relationship qualities that make it more difficult for romantic partners to connect sexually. The mechanisms of turbulence could predict these sexual intimacy challenges. If a person with depression is
experiencing relational uncertainty, ambiguity surrounding the relationship could prompt feelings of isolation, making it difficult to maintain a sexually intimate relationship. Similarly, when partners are disrupting each other’s day-to-day routines, those goal blockages can fuel negative emotions, which might inhibit a partner’s libido or limit efforts to initiate sex. To test the logic that mechanisms of turbulence predict sexual intimacy challenges for depressed couples, I propose a second hypothesis.
H2a: Relational uncertainty will be positively associated with sexual intimacy challenges. H2b: Interference from a partner will be positively associated with sexual intimacy challenges.
Sexual intimacy challenges and sexual satisfaction. One outcome of the unique sexual intimacy challenges for depressed couples is likely to be decreased sexual satisfaction. A third prediction proposes that the sexual intimacy challenges related to depression correspond with decreases in overall sexual satisfaction. The sexual intimacy challenges specific to depression (e.g., lack of desire, struggling to act on desire, feelings of isolation, difficulties initiating sexual activity) should associate with decreases in overall sexual satisfaction. Evidence exists that individuals with depression are prone to impaired sexual satisfaction (Bodenmann & Ledermann, 2007; Ecklund & Ostman, 2010; Ishak et al., 2013), and the unique sexual intimacy challenges that depressed couples face may be a contributor to those decreases in sexual satisfaction. Research has also uncovered evidence that both partners are affected by the sexual challenges that come along with depression, such that even non-depressed partners can experience lower
association, a third hypothesis predicts a negative association between sexual intimacy challenges and sexual satisfaction.
H3: Sexual intimacy challenges will be negatively associated with sexual satisfaction. Relational turbulence and sexual communication. The RTM suggests that sexual communication, which is a challenging task generally, is especially difficult when partners are experiencing relational uncertainty and interference from a partner. For example, a partner experiencing ambiguity about the relationship may be hesitant to bring up sexual topics because he/she is not able to predict how his/her partner will react, and partners who are frustrated over disruptions to routines or goals being blocked might communicate in reactive and hostile ways. In sum, under turbulent conditions, sexual communication between partners might be
particularly daunting.
The RTM offers relational uncertainty, in particular, as a theoretical construct that may be useful in explaining the dynamics of couples’ communication about their sexual relationship (Theiss, 2011; Theiss & Nagy, 2010). Knobloch (2008) identified the sexual relationship as an area where married partners can experience relational uncertainty. Further, relational uncertainty is related to decreased sexual satisfaction for both actors and partners (Theiss & Nagy, 2010). More specifically, one’s own ambiguity about the relationship is linked to lower levels of satisfaction, and a partner’s relational uncertainty associates with sexual discontentment. Theiss and Nagy (2010) illustrated the utility of relational uncertainty for the study of sexuality by noting how the sexual partnership can change as the relationship endures. In light of career stressors, the potential addition of children, aging, etc., partners may face ambiguity about the relationship, which can shape the sexual climate of the relationship. As couples grapple with changes to the relationship, they must re-align and re-negotiate their norms and expectations for
the relationship, necessitating communication about sex (Theiss & Nagy, 2010). Existing research positions relational uncertainty as useful for studying sexual relationships, and in particular, the study of sexual communication.
Relational uncertainty can make it more difficult for partners to communicate effectively in general, and indirect or passive communication about sex can be associated with decreased sexual satisfaction for both individuals and their partners (Theiss, 2011). Theiss (2011) claimed that relational uncertainty primarily affects romantic relationships by hampering partners’ efforts to communicate effectively. In her findings, communicative indirectness about sexual intimacy mediated the connection between relational uncertainty and sexual satisfaction, indicating that difficulty in conversations about sex may be the tie between ambiguity about the partnership and perceptions of the sexual relationship. Additionally, Theiss (2011) found a positive association between husbands’ indirectness of sexual communication and their wives’ satisfaction, and vice versa. In other words, the way one partner communicates about sex corresponds with his or her partner’s sexual satisfaction. Theiss (2011) concluded that there are both intra- and inter-personal processes that shape sexual satisfaction for married partners (p. 577). These findings suggest that the relational turbulence model is useful for explaining the ties between questions about the partnership and the communication dynamics of the couple.
Most sexual communication research guided by the RTM has specifically highlighted the construct of relational uncertainty, but one study has tested the full model in this context. Theiss and Estlein (2014) turned to the RTM to examine how communication about sex can be
corresponded with indirect sexual communication and the avoidance of sexual conversations. Theiss and Estlein (2014) concluded that perhaps the association between the mechanisms of relational turbulence and sexual communication is not a direct one, and the cognitive reactions to relationship conditions are a more proximal predictor of people’s behaviors (Theiss & Estlein, 2014). Further, Theiss and Estlein (2014) found that avoiding conversations about sex (for both males and females) and indirect conversations about sex (for females) associated negatively with sexual satisfaction. This study, then, shed light on the utility of examining relational turbulence processes in couples’ sexual relationships and also positions communication as central to couples’ perceptions of sexual satisfaction.
One strength of using the RTM in the study of sexual communication is that it maintains a strong foundation in the study of communication processes. Relational uncertainty can
influence message production and message processing (Knobloch, 2006; Knobloch, Miller, Bond, & Mannone, 2007). Further, relational uncertainty explains why sexual communication is challenging and dissatisfying when done indirectly (Theiss & Estlein, 2014). The RTM literature on sexual communication has prioritized a focus on relational uncertainty (eschewing
interference from a partner) as a factor in couple’s sexual communication. Even though the study of relational uncertainty sheds substantial light on these interactions, the literature as it stands lacks the explanatory power of the full theory. Relational uncertainty and interference from a partner can both associate with polarized communication between partners (Solomon & Knobloch, 2004). These mechanisms of relational turbulence are tied to topic avoidance, withdrawal, indirect communication, decreased openness, and destructive conflict behaviors (Knobloch & Theiss, 2011; Theiss & Nagy, 2013; Theiss & Solomon, 2006a). Scholars should
build on the work initiated by Theiss and Estlein (2014) by including both relational uncertainty and interference from a partner in their research on sexual communication.
Quality of sexual communication. A first step in positioning communication about sex within the framework provided by the RTM is continuing to explicate what, exactly, constitutes good sexual communication. Given the range of definitions of sexual communication and the disproportionate focus on openness, disclosure, and directness, the literature stands to benefit from refined consideration of what features of conversation matter in sexual communication. In contrast to studies that have characterized sexual communication based on disclosure (e.g., Byers & Demmons, 1999) or directness (e.g., Theiss, 2011), sexual communication in this case is conceptualized as the individual’s perceived quality of the couple’s interaction(s). Restricting conceptualization and measurement to a specific quality of interaction, such as directness, limits the scope of findings on these interactions. For example, while some partners may find a
particular approach successful, such as directly stating a complaint to a partner (e.g., “I really don’t think we have enough sex”), others may find that approach threatening and consider a more oblique tactic to be more manageable (e.g., “How much sex do you think is normal for couples like us?”).
As a precursor to reasoning about the role of sexual communication in turbulence processes, then, the second research question inquires into the dynamics of sexual
communication between depressed individuals and their partners, and the third research question aims to delineate more and less successful tactics within those conversations. These research
RQ3: What features of conversations about sex do partners perceive to be more or less successful in maintaining or improving their sexual relationship?
A successful climate for sexual communication may include feeling comfortable in discussion with a partner, a partner’s response to disclosure, or an ability to resolve
disagreements about sexual topics, amid other constructive qualities of conversation. As a first step in improving conceptualization and measurement of sexual communication, I will consider one broad and one narrow conceptualization of quality sexual communication. First, a global appraisal of quality of sexual communication is rooted in Catania’s (2011) evaluation of people’s perceptions of communication about sexual topics. Evaluating quality of sexual communication broadly incorporates several aspects of conversation, including responses between partners, emotional tone of the conversation, avoidance of interactions, and whether or not partners have ever had a conversation about sex. Second, guided by Spitzberg and Canary’s (1985)
conceptualization of communication competence, which positions perceptions of appropriateness and effectiveness as central to successful communication (c.f. Canary & Spitzberg, 1987, 1989), I assert that perceiving conversations as effective is key to quality sexual communication. The premise of the RTM implies that partners grappling with relational uncertainty and interference from a partner are less effective at engaging in quality sexual communication. Overall quality and specifically effectiveness are two ways to consider how partners may perceive sexual communication as successful.
The MDD and the RTM agree that extremes in communication are common in relationships marked by depression. The RTM suggests that relational uncertainty and interference from a partner lead to extremes in cognitive, emotional, and communication responses to relationship events (Solomon & Knobloch, 2004). Recent work on depressed
couples has situated specific communication processes as critical in the link between
mechanisms of turbulence and relationship outcomes (e.g., Knobloch et al., 2011). Similarly, the MDD highlights intensified negative reactions as one of the problematic processes driving relationship troubles for depressed couples. For example, depressed partners are inclined to see relationship events as catastrophic or exceptionally stressful (Beach et al., 2003). Moreover, the MDD positions communication behaviors (e.g., supportive interactions, criticism) as central to the relationship climate (Beach et al., 1990).
People’s sexual communication is likely to be less effective when they manage
depression in their relationship, as both the RTM and MDD contend that communication under conditions of turbulence can be characterized by destructive conflict tactics, harmful avoidance of conversations, and withdrawal. Taken together, these theories suggest that the effectiveness of romantic partners’ communicative responses may be hampered by the turbulence manifest in sexual intimacy challenges. Based on this reasoning, a fourth hypothesis posits that sexual intimacy challenges associate negatively with the quality of sexual communication.
H4: Sexual intimacy challenges will be negatively associated with quality of sexual communication.
Additionally, in light of evidence that successful sexual communication can boost sexual satisfaction (Babin, 2013; Byers, 2005; Cupach & Comstock, 1990; Theiss, 2011), hypothesis five predicts a positive association between sexual communication and sexual satisfaction.
